| Entity Name: | ROSE WELLNESS CLINIC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 20 Mar 2015 (10 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 08 Oct 2018 (6 years ago) |
| Document Number: | L15000050528 |
| FEI/EIN Number | 47-3450222 |
| Address: | 910 OLD CAMP RD, SUITE 92, THE VILLAGES, FL 32162 |
| Mail Address: | 910 OLD CAMP RD, SUITE 92, THE VILLAGES, FL 32162 |
| ZIP code: | 32162 |
| County: | Sumter |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598159576 | 2015-03-26 | 2022-08-30 | 910 OLD CAMP RD, SUITE 92, THE VILLAGES, FL, 321625604, US | 910 OLD CAMP RD, SUITE 92, THE VILLAGES, FL, 321625604, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 386-334-0133 |
| Phone | +1 352-775-2180 |
| Fax | 3527752930 |
Authorized person
| Name | CHAD ROSE |
| Role | OWNER |
| Phone | 3527752180 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH11031 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | 053562 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 225100000X - Physical Therapist |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 009SS |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ROSE, CHAD M | Agent | 910 OLD CAMP RD., SUITE 92, THE VILLAGES, FL 32162 |
| Name | Role | Address |
|---|---|---|
| ROSE, CHAD M | Manager | 910 OLD CAMP RD., THE VILLAGES, FL 32162 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2018-10-08 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| REINSTATEMENT | 2016-10-26 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-10-26 | ROSE, CHAD M | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-05 |
| ANNUAL REPORT | 2024-02-29 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-03-20 |
| ANNUAL REPORT | 2019-01-08 |
| REINSTATEMENT | 2018-10-08 |
| ANNUAL REPORT | 2017-04-19 |
| REINSTATEMENT | 2016-10-26 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 8262677406 | 2020-05-18 | 0491 | PPP | 910 Old Camp Rd Ste #92, The Villages, FL, 32162 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 20 Feb 2025
Sources: Florida Department of State
